Pyoderma Gangrenosum: The Great Pretender and a Challenging Diagnosis

作者：Wong Wendy W^*; Machado Gustavo R; Hill Michael E

来源：Journal of Cutaneous Medicine and Surgery, 2011, 15(6): 322-328.

DOI：10.2310/7750.2011.10119

Background: The initial presentation of pyoderma gangrenosum (PG) is virtually indistinguishable from a pyogenic infection, making debridement appear necessary. However, operative approaches often lead to exacerbation and rapid extension through pathergy.
Objective and Methods: In attempts to increase awareness of this condition and minimize misdiagnoses, a review of published reports involving PG of the hand and digits was performed and included 35 patients in addition to our case of a 14-year-old female with a history of ulcerative colitis.
Results: Of the total cases, 29 patients were misdiagnosed as having an infection and subsequently treated with antibiotics; 13 of these patients also had debridement of their lesions. Twenty-eight patients had associated medical conditions, including ulcerative colitis, Crohn disease, diabetes mellitus, and cancer.
Conclusion: When approached with a rapidly growing ulcerated lesion that does not respond to operative therapy, the possibility of PG should be entertained and a high-dose corticosteroid regimen and/or immunomodulator therapy implemented.

• 出版日期2011-12